Q. A doctor has prescribed spironolactone to my 22 year old daughter for hirsutism. Is that drug effective and safe?

A. Spironolactone (Aldactone) is a diuretic used to control high blood pressure, but it is also prescribed to treat unsightly facial hair growth in women. This condition is sometimes associated with an excess of male hormones (androgens). Spironolactone has anti-androgen action and counteracts this problem. Side effects may include drowsiness, diarrhea, cramping, and menstrual irregularities.

Animal studies have raised questions about the long-term safety of this medication, however. It causes tumors in rats and the FDA has cautioned that “Unnecessary use of this drug should be avoided.”

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  1. Laura

    This is incorrect information received in the reply to your message. It would be best in the first instance to refer her to her own Dr if you/she have any concerns in future. They will have access to a full medical history and medications list which enables the Dr to make an informed and safe decision for your daughter. He can look (in general) at side effects, age, weight, Blood pressure, other medical conditions, latest blood results and medication etc. You can also refer to the patient leaflet and RELIABLE websites such as the MAYO clinic, webmd or patient.co.uk which are all monitored and overseen by Fully qualified Medical professionals. No medicine is without any side effects however the patient and Dr decide together whether to proceed and if the benefit(s) outweighs the risks/side effects. A significant number of people experience one or two side effects in the first few days or weeks. Depending on what the side effect is ie an allergic reaction to penicillin, seek Drs advice immeadiatly, will dictate your response.

    Spironolactone like all drugs, was tested on live animals to ensure its safety and efficacy. It was tumourigenic (tumour forming) only in continual maintained TOXIC levels in rats. This means the rats received an overdose of the medication over a prolonged period. Therefore, if you took paracetamol 4 times the normal dose for an extended period you might expect to see some extremely serious consequences including death but at the normal dosage it is completely safe (based on a healthy adult). If there was any link or study to show there was a real identified risk such as tumour’s the FDA or drug authority of your country would pull it off the market and it would never have reached human trials. so please be assured by that. It is not possible to say whether or not it will be effective in your daughters case.

    Here I draw on my own experience to share with you. I take 50mg Spiro with food (aids absorption and effectiveness). I take it for hirsutism and hair loss in PCOS. On commencement I needed a 2 week, then a further month on blood test to check potassium levels (essential for all on this drug – as its a potassium sparing diuretic ) LFT’s, U&E’s and hormone panel. I was weighed and blood pressure checked. The initial dose was 25mg for 2 weeks and then 50mg there after provided it was tolerated. Please bear in mind I take a lot of other medications which makes it more likely I am experiencing side effects as a combined process and because of other medical conditions.
    Within a few days my appetite dropped completely. Around three weeks later, I noticed that the fluid I had accumulation in my abdomen (which my own dr repeatedly disregarded due to other medical issues) decreased as it began to become slightly less protruding – because its a diuretic which removes excess fluid from the body by stimulating the kidneys to produce urine. I lost a few kg probably in fluid. After around 3 months I noticed the hair on my arms was getting lighter/fairer and growing at a slower rate so I did not have to bleach it as often. At around 4 months my facial hair also started to lighten back up (it was not that dark neither was my arm hair but enough to bother me). The odd stray thick black hair on my face had started to come through less frequently. The hair on my arms had lightened further and was growing even slower. As a consequence this significantly improved my skin condition a severer form of keratosis pilaris aka chicken skin. (due to the slowing of hair growth affecting the keratin build up). I am now at 5 1/2 months. Hair on my legs and under arms is now slowed (this seemed to take much longer than anywhere else to slow. I postulate this may be due to the hair thickness/darkness ie the thicker the hair the longer it takes to see results. Some of the fluid on my abdomen appears to have returned. I am experiencing possible urinary system problems (which I have never had before) as a side effect, however this could just be a red herring. This is being investigated but is a very unusual side effect if indeed it is. I left this until last because this side effect is said to effect the few rather than the many and I already have multiple pre existing health conditions which are possibly exacerbating/predisposing me to this effect. Within a week of commencement I noticed significant increased hair shed which continued and peaked between 1-4 months. I already had diffuse thinning hair not patchy, due to a combination of reasons. It made me really anxious, so I requested an early review. However I did my research. There is some speculation and science to explain what people have termed the” dreaded shed”. Once the Spiro starts to cause its mechanism of action on the hair folicles ie it stimulates new hair growth by switching the hair from the resting phase to the active phase which in turn pushes out the old hair and and begins growing anew meaning an initial hair loss and lag time as new hair grows back in. At present the amount of hair shedding seems to be decreasing. I am monitoring it closely and to evaluate whether I wish to continue the treatment or not. At present I am continuing in the hope that this phase of shedding will pass and my hair will begin to thicken. I am having a review in 3 weeks time.

    I hope this helps others who also find this post some time later, as I have. . . thanks :)

  2. Robyn
    United States

    Ever since I had my son, my only child, I have gradually noticed hair on my chin. Before I became pregnant there was instances which stray hair would appear on my neck.. Now my son is 13, and my chin, all the way to left and right of my jaw (chin) plus under the jaw, and along the neck. The hairs are so coarse that when I shave or pluck upsets the hair follicle I get huge cystic acne.

    I have done over 12 sessions of laser hair removal – It never had an effect!! It was at that point I started to shave my face.. In order for the laser to be most effective you must not pluck. I spend over 30 minutes a day, with a 12x’s lighted mirror and $40 tweezers and shave 1 – 2 times a day with a Gillette fusion razor, which I replace every 3-4 days or else horrible razor bumps!

    I have been taking spironactone (spelling?) for over a month. I started at 25mg in morning then another at night. My doctor did regular blood work because potassium can be negatively affected. I did notice much more fragrant urine – strong ammonia scent. Currently I am taking 50mg of the medication in the morning and another 50mg at night. I have still to see any improvement in the hair on my chin, under chin, neck, and even upper lip..

    Based upon some research I have done, there are other drugs, some that aren’t FDA approved, but my insurance covered it? (weird!) have been shown to have a 49% reduction in male hair growth patterns in women. I get numerous ovarian cysts that burst- not fun – therefore my doctor concludes I have polycystic ovarian…

    This really sucks that every morning I have to lather up my chin and neck with shaving cteam, spend over $100 in razors (so I get the closest shave possible), and wear cosmetic foundation on my face and NECK!!
    For anymore on this site.. This is what I found helpful :) GOOD LUCK


  3. Kim

    I took Spironolactone between ages 15 and 19 for hirsutism. I took it in combination with a birth control pill to help with Polycystic Ovarian Syndrome issues, and it worked awesomely. Shortly after beginning the med, my hair got finer and lighter colored, my acne cleared up, my cramps stopped almost completely. I stopped taking it because I was no longer covered under my previous insurance. I was still on the birth control meds but all of my PCOS issues came back, including the hair.
    I never noticed mood issues before (maybe because I was a teenager), but a few years later now I am back on the drug and having some difficulties. It isn’t drastic, but I am noticing a bit more irritability. Otherwise Spironolactone has helped to move my weight away from my belly and into more feminine areas, get rid of acne and facial hair, and even thinned my eyebrows a bit. I love this medication.

  4. KR

    What would you suggest for unsightly facial hair? I have a few of those, and also, as my sister calls them, “man elbows”. They have pretty long black hair on them. I’ve always had hairy arms, but now it seems to growing around the underside of my arm. I’m 40 years old, still have regular periods, but maybe this is a hormone issue? I do have PMDD.

  5. D.V. IBANEZ

    Thanks for the information. I was considering the drug, but I’m glad I had your source to guide me, this drug is not for me.

  6. Loretta

    I’ve suffered with facial hair all my life… especially on my upper lip. I suffered thru the constant bleaching, then depilatories (which burned my face terribly), then thru waxing (which also burned my face many times), eventually relying on constant plucking with tweezers… my nightly ritual for years. I got so tired of that so I bought a mini electric razor and started shaving it.
    Then I decided to spend the money and get the laser hair removal. It worked extremely well! I suggest you don’t wait until your hair starts turning grey, because the laser will only zap the dark hairs.
    I’m very happy that I got the laser treatment and I highly recommend it. If you have resorted to shaving over the years, you will have to stop that and let it grow back before you can get good results with the laser treatment. Try to find a dermatologist who your friends have gone to and gotten results. Not all dermatologists are what they are cracked up to be.

  7. lcf

    My husband was prescribed this medication for a heart condition. He is usually an easy-going individual with a pretty laid-back personality. Shortly after taking Spironolactone, his personality started to change. I thought I was living with Dr. Jekyll and Mr. Hyde! He was irritable, critical and downright nasty. A followup trip to the doctor’s office revealed that mood changes were part of the side effects of this med. My husband stopped taking it immediately and guess what? He is back to his sweet self. Turned out he didn’t need the med after all.

  8. Dot F.

    Aldactone also causes increased breast size in both women and men. My husband was on Aldactone prior to liver transplant and it has taken him 10 years to lose his “man” breasts. Our daughter was also prescribed the medication and she has considered breast reduction surgery. In my husband’s case it was prescribed for edema, but knowing what we do now we would have asked for something different.

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